甲状腺舌管囊肿与瘘的诊断和治疗

Diagnosis and treatment of thyroglossal duct cyst or fistula

目的 探讨甲状腺舌管囊肿与瘘的诊治问题。方法 回顾性分析我院手术治疗 6 7例甲状腺舌管囊肿与瘘患者的临床资料。结果 本组术前诊断率为 92 .5 % ,行B超检查者诊断准确率为96 .1% ;全组均行手术治疗 ,其中作单纯切除 14例 ,连部分舌骨骨膜切除 12例 ,连舌骨中段切除(Sistrunk's手术 ) 41例。 5 4例获随访 ,其中随访舌管囊肿患者 43例 ,复发 4例 ,复发率 9.3% ;随访瘘管患者 11例 ,复发 2例 ,复发率 18.2 %。结论 高频超声检查对甲状腺舌管囊肿的诊断及鉴别诊断具有一定特征性及临床价值。术后复发原因与手术方式以及术前感染是否控制有关 ,在囊肿未感染前正确施行Sistrunk's手术可降低术后复发率。

Objective To study the Diagnosis and treatment of thyroglossal duct cyst or fistula. Methods The clinical data of 67 patients with thyroglossal duct cyst or fistula treated by surgery were analyzed retrospectively. Results The diagnosis rate preoperatively was 92.5% and the accuracy diagnosis rate by B type ultrasonography was 96.1%; all cases were treated by operation, of them, 14 cases underwent simple cyst resection, 12 with resection of partial periosteum of hyoid and 41 with resection of middle segment of hyoid( Sistrunk's operation ). 54 cases were followed up, recurrence in cases with cyst was 4 of 43 (9.3%) and recurrence in cases with fistula was 2 of 11(18.2%)respectively. Conclusion Ultrasonography shows certain characteristics and clinical value to diagnose and distinguish thyroglossal duct cyst. Postoperative recurrence is due to the selection of operation procedures and control of infection of focus. The Sistrunk's operation properly performed previou to cyst infection should reduce recurrence rate markedly.